The International Campaign to Abolish Nuclear Weapons (ICAN) was awarded the Nobel Peace Prize in December 2017 "for its ground-breaking efforts to achieve a treaty-based prohibition" of nuclear weapons. But the Treaty on the Prohibition of Nuclear Weapons (TPNW), adopted at the UN by 122 governments earlier that year, is not only a ban treaty.

During the negotiations, a small team of ICAN campaigners also worked to ensure that the Treaty included "positive obligations" that address the ongoing humanitarian, human rights and environmental harms of nuclear weapons use and testing.

After the negotiations, ICAN's "PosObs" team, as we called ourselves, realized that ensuring implementation of the TPNW's provisions on victim assistance, environmental remediation and international cooperation and assistance required considerable further work.

As a result, under the auspices of Pace University's International Disarmament Institute, where I work, we have started doing research on how nuclear weapons use and testing have affected people and environments, focusing particularly on the Pacific region.

In January 2018, I travelled to Kiritimati (Christmas) Island where, along with nearby Malden Island, the UK and USA conducted 33 atmospheric nuclear tests between 1957 and 1962. British, Fijian, New Zealand and American veterans of the testing program and i-Kiribaticivilians who lived on Kiritimati claim their health (as well as their descendants' health) was adversely affected by exposure to ionizing radiation. Their concerns are supported by independent medical research.

The UK and US testing program at Kiritimati relied on racist discourses that framed it, as a British military magazine put it, as a "lonely island … boasting little more than a few coconut palms." But about 100 i-Kiribati civilians lived on Kiribati, employed by a copra plantation and the military base. The number increased to almost 500 i-Kiribati civilians by the end of the tests.

I spoke with Teeua Tetua, President of the Kiritimati Association of Cancer Patients Affected by the British and American Bomb Tests, who was a child at the time of the UK tests. "We felt uncomfortable every day," she said, describing the persistent anxiety caused by living on an island bombarded by nuclear detonations.

Teeua Tetua remembers gathering on the tennis courts in the village, in the middle of the night before a test. She said "the people were really afraid." She describes the blast as very hot and so loud that "people tried to put their fingers in their ears."

The Association has identified 48 survivors who experienced the tests first hand, as well as 800 descendants. Members of the Association report numerous health problems which they attribute to the testing, including blindness, hearing problems, cancers, heart disease and reproductive difficulties. They also report that their children and grandchildren have suffered similar illnesses. Survivors are "worried about the disease in their bodies," said Teeua Tetua.

In two reports we published in May ‒ one on Kiritimati and one on Fijian test veterans1,2 ‒ I outlined how the TPNW's positive obligations could offer a way to assist the people who are suffering from the impact of the nuclear tests in Kiritimati. While the British, US, Fijian and New Zealand governments have, to greater and lesser extents, responded to demands from test veterans for recognition and assistance, i-Kiribati survivors have had little help or acknowledgement.

While the debate about helping civilian victims and test veterans has often been framed only in terms of compensation from the testing state, the TPNW frames assistance broadly, including "medical care, rehabilitation and psychological support, as well as … social and economic inclusion" (Article 6[1]).

This means we do not need to wait for the nuclear-armed states to have a change of heart to help those people they harmed. Teeua Tetua said the desire for compensation was "not about money, but about doctors and medicine" ‒ they need help addressing their health problems.

We can also think of more broadly remedial and restorative measures. For instance, we have learned from our research that many survivors want recognition of what happened to them. "It should be known by the world, the cruel things that have been done," Teeua Tetua told me. She says that there are few systems in Kiritimati for archiving and disseminating information about the impact of the nuclear tests and the potential health risks for those who may have been exposed to radiation. Association members have called for a monument in Kiritimati memorializing the suffering caused by the nuclear testing.

Recently, we have expanded our work beyond Fiji and Kiribati to research the impact of nuclear testing elsewhere in the Pacific. We are finding similar neglect of the needs of both civilian and military survivors and disregard for the rights of Indigenous peoples. But we also see the efficacy of the TPNW's holistic approach, rooted in humanitarian, human rights and environmental norms.

For example, in October, we published a report on Australia, authored by Dimity Hawkins of Swinburne University. She outlined the complex, overlapping histories of harm caused by the UK nuclear weapons program in Australia, from the detonations themselves, to uranium mining, displacement of Aboriginal communities and lands contaminated by fallout.3

Unlike Kiribati and Fiji, which have both signed the TPNW, Australia boycotted the negotiations and on 1 November was the only state subjected to nuclear testing by another other state to vote against a UN resolution calling for the TPNW's universalization.4

However, the framework offered by the TPNW's positive obligations offers a way for affected communities in Australia to seek solidarity from others around the world. I like to tell skeptics that the TPNW's provision on victim assistance has already had a normative effect, because it has made people at a university in New York pay attention to the impact of nuclear weapons on communities on the opposite side of the world.